Namine is on contact isolation here in the hospital; that means that nurses and doctors must don their gowns and gloves when entering the room, but we – by we I mean her family, not just Jessica and myself – mustn’t. And as for the reason she’s on isolation at all? The culture taken from the open wound on her chest incision came back positive for MRSA.
Before the culture came back, Namine had been placed on clindamycin for treatment. Unfortunately, that was about the last thing on which they should have put her: the strain of MRSA Namine has is resistant to it. So yesterday Namine was placed on vancomycin, which can only be given through an IV.
It hasn’t yet been determined if Namine will remain on the vancomycin for the long haul. If so, it will be for another couple weeks, at least. But I’m getting ahead of myself; we must wait for a visit from the fine people in the infectious diseases department, who will determine if she has to be on vancomycin or something else. Bactrim could be a viable alternative, if the infectious diseases people see fit to prescribe that instead; and that’s an oral antibiotic.
If Namine can be on the bactrim, she could go home today. But if she has to stay on the vanco, she’ll have to have a PICC line placed in order to go home. We’re told that the line placement wouldn’t happen until tomorrow.
All of this neatly sidesteps the real issue: the open wound in Namine’s chest. The antibiotic treats the infection in the wound, of course, but does nothing for closing the wound itself. For that, we will be talking with Namine’s operating surgeon. He is responsible for the surgery, and thus the incision, after all; he can tell us how best it may be closed. There had been talk some days ago about taking her back into the OR in order to reopen and then suture the incision back up again, this time perhaps with a different material. Despite that, the approach for the time being seems to be a simple dry dressing, lightly taped over the incision. The surgeon will be able to advise us further.